Behavioral changes

Changes in appetite, such as decreased appetite and weight loss, or increased cravings for food and weight gain

Use of alcohol or drugs

Agitation or restlessness — for example, pacing, hand-wringing or an inability to sit still

Slowed thinking, speaking or body movements

Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse

Poor school performance or frequent absences from school

Neglected appearance — such as mismatched clothes and unkempt hair

Disruptive or risky behavior

Self-harm, such as cutting, burning, or excessive piercing or tattooing

What's normal and what's not

It can be difficult to tell the difference between ups and downs that are just part of being a teenager and teen depression. Talk with your teen. Try to determine whether he or she seems capable of managing challenging feelings, or if life seems overwhelming.

If depression symptoms continue or begin to interfere in your teen's life, talk to a doctor or a mental health professional trained to work with adolescents. Your teen's family doctor or pediatrician is a good place to start. Or your teen's school may recommend someone.

When to see a doctor

If you suspect your teenager is depressed, make a doctor's appointment as soon as you can. Depression symptoms likely won't get better on their own — and they may get worse or lead to other problems if untreated. Depressed teenagers may be at risk of suicide, even if signs and symptoms don't appear to be severe.

If you're a teen and you think you may be depressed — or you have a friend who may be depressed — don't wait to get help. Talk to a health care professional such as your doctor or school nurse. Share your concerns with a parent, a close friend, a spiritual leader, a teacher or someone else you trust.

Suicidal thoughts

If your teen is having suicidal thoughts, get help right away. Take all talk of suicide seriously. Here are some steps you can take:

Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor or encourage your teen to do so.

Seek help from your doctor, a mental health provider or other health care professional.

Reach out to family members, friends or spiritual leaders for support as you seek treatment for your teen.

When to get emergency help

If you think your teen is in immediate danger of self-harm or attempting suicide, make sure someone stays with him or her. Call 911 or your local emergency number immediately. Or if you think you can do so safely, take your teen to the nearest hospital emergency department.

Carpenter DJ. St. John's wort and S-adenosyl amethione as "natural" alternatives to conventional antidepressants in the era of the suicidality boxed warning: What is the evidence for clinically relevant benefit? Alternative Medicine Review. 2011;16:17.

Tanyi RA, et al. The effects of psychoneuroimmunology (PNI) based lifestyle intervention in modifying the progression of depression in clinically depressed adults. International Journal of Psychiatry in Medicine. 2011;42:151.

Wu J, et al. Acupuncture for depression: A review of clinical applications. The Canadian Journal of Psychiatry. 2012;57:397.

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